2006 3 8 3 J Ultrasound in Clin Med,March 2006, Vol. 8, NO. 3 139 (CFI),,, 34,Π 19,;15,(CFVR, ), 34 CFVR CFVR (2. 86 0. 40 vs 3. 30 0. 28, P < 0. 05), CFVR ;,,; CFVR ;; The clinical research of the measurement of coronary flow reserve by noninvasive coronary flow imaging in patients with angiographically normal coronary arteries Yang Ya,Li Zhian,Wang Lijun Department of Ultrasound,Anzheng Hospital affialited to Capital medical university,beijing 100029,China ABSTRACT Objective To validate the feasibility of the measurement of coronary flow velocity reserve (CFVR) by noninvasive coronary flow imaging (CFI) and to evaluate the CFVR in patients who had chest pain and angiographically normal coronary arteries by this method. Methods CFVR was measured in the distal left anterior descending artery (LAD) in 34 subjects with angiographically nor2 mal coronary arteries, including 19 patients with chest pain and 15 normal control subjects by CFI at baseline and hyperemic conditions (intravenous administration of adenosine 140g. kg - 1. min - 1 ). CFVR was defined as the ratio of hyperemic to basal mean diastolic ve2 locity. Coronary flow velocity and CFVR were studied in 19 patients and compared to 15 normal subjects.results CFVR was success2 fully measured in 34 subjects. In 19 patients, CFVR of LAD was lower than control subjects (2. 79 0. 43 vs 3. 30 0. 28, P < 0. 05). There was no significant difference of coronary flow velocity both at baseline and hyperemic conditions in patients and normal control sub2 jects. Conclusion Noninvasive CFI combined with adenosine stress experiment provides a reliable measurement of CFVR in the distal left anterior descending artery. CFVR is impaired in patients with chest pain and angiographically normal coronary arteries. Hypertension and hyperlipidemia are the reasons of the reduction of CFVR. KEY WORDS coronary flow imaging ;coronary flow reserve ;Coronary angiography (Coronary flow reserve,cfr),,,, (Cor2 onary Flow Velocity Reserve,CFVR) CFRCFVR [1 ],CFVR CFR [2 ] CFVR :(7042023) :100029,
140 2006 3 8 3 J Ultrasound in Clin Med,March 2006, Vol. 8, NO. 3 [1 ],,,, (CFI),,CFVR,,,10 %30 %,,,CFVR [3 ],,CFR [4. 5 ] [6 ],,CFR CFVR,, CFVR CFI CFVR,, CFI CFVR, 34 19,11,8, 4167, (56 6. 7),( 140Π90 mm Hg) Π ( 230 mgπml Π 160 mgπml), ;15,9, 6, 2075, (53 15. 4),,, Sequoia C 256 Vivid 7, (LAD), LAD LAD LAD > 30, LAD,,140g kg - 1 min - 1 3 min,,, LAD, (bpdv) (bmdv) ( hpdv) (hmdv),cfvr,cfvr = hmdvπbmdv SPSS 11. 0,,t, P < 0. 05 CFI CFVR 34,,CFVR 100 %, 12 min, (1) 1 ( %) 27 79 15 44 14 41 12 35 10 29,, (2) bpdv bmdv,
2006 3 8 3 J Ultrasound in Clin Med,March 2006, Vol. 8, NO. 3 141 ;hmdv, ; CFVR, (3) 2 (Πmin) (mm Hg) (mm Hg) 65. 03 11. 12 124. 23 17. 99 75. 80 11. 31 83. 00 16. 90 115. 71 19. 65 70. 53 13. 59 P P < 0. 001 P > 0. 05 P > 0. 05 3 ( gx s) bpdv(cmπs) hpdv(cmπs) bmdv(cmπs) hmdv(cmπs) CFVR 25. 86 6. 42 70. 03 18. 43 20. 88 4. 93 58. 19 16. 22 2. 79 0. 43 23. 61 6. 70 65. 50 23. 82 18. 86 2. 82 62. 49 10. 81 3. 30 0. 28 P P > 0. 05 P > 0. 05 P > 0. 05 P > 0. 05 P < 0. 001 CFI, CFVR, CFI CFVR,,,,, Hozumi [7 ],CFI ( ICD) CFVR, CFI CFVR,,CFI,, 90 % [8 ],,CFI 95 %100 % [9 ],CFVR, 100 % CFVR,,,,, 68 min,,, 30 min,,, [10 ],,,,, ( < 10 s),2 min,,, 12 min,,cfvr,, 140 g kg - 1 min - 1, 23 min CFVR,, 6 min,31 6 min,3 6 min, 2 min,, 12 min,, CFVR,, CFVR,,,,,, Erbel [3 ] 44 ICD,16 (36 %),CFVR > 3. 0, [11 ] CFVR, CFVR,, CFVR, ICD,
142 2006 3 8 3 J Ultrasound in Clin Med,March 2006, Vol. 8, NO. 3,CFVR [12 ] CFVR,, CFVR,,,CFVR > 3. 0 [13 ],CFI ICD CFVR,ICD CFVR 3. 0,CFI CFVR 95. 7 % 8010 %, CFVR 3. 0,,,,CFVR [12 ], [4. 5 ] [14 ] ICD CFVR,,, 16 %CFVR,CFVR Vokoyama [4 ], CFVR,19,,CFVR, CFVR,,, [15 ] CFVR [4 ],,,,,Fuji2 moto [16 ],16 Fluvastatin 3,, CFVR (3. 0 0. 5) (3. 5 0. 8),,,, [17 ],CFVR,,,,, [18 ],,CFVR,,CFVR < 2, CFVR CFVR,,CFVR CFR [2 ],,CFVR CFR [13 ] CFI LAD,,30,,CFVR : CFVR () () CFVR [12,19 ] ICD,CFI CFVR,,,, CFVR, ; CFVR ;,, ; CFVR 1 Gould KL, Lipscomb K, Hamilton GW. Physiologic basis for assessing criti2 cal coronary stenosis : Instantaneous flow response and regional distribution during coronary hyperemia as measures of coronary flow reserve. AmJ Cardi2 ol, 1974, 33 : 8794. 2 Doucette JW, Corl PD, Payne HM, et al. Validation of Doppler guide wire for intravascular measurement of coronary artery flow velocity. Circulation, 1992, 85 :18991911. 3 Erbel R, Ge J, Bockisch A, et al. Value of intracoronary ultrasound and Doppler in the differentiation of angiographically normal coronary arteries : a prospective study in patients with angina pectoris. Eur Heart J, 1996,17 : 880889. 4 Yokoyama I, Ohtake T, Momomura S, et al. Reduced coronary flow reserve in hypercholesterolemic patients without overt coronary stenosis. Circulation, 1996, 94 :32323238.
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